Bad PVC's- Think it's Hormonal- Help!

[canihelp]

I'm 51 female.  Over 4 months ago I got hormone pellets inserted in hip. (natural type).  I had been having hot flashes & some PVC's.  I've had PVCs/palpitations since age 28.  Last EKG & 2 week holter monitor just 7-8 mos. ago.  It picked up some PVCs/PACs- benign.  No concern on doctor's part.  Since I got the pellets (estrogin/progestin/testosteron) I felt wonderful for about 2 weeks.  I'd only been menopausal for a couple months, so evidentally my body started producing its own estrogen again, as I got estrogen dominant & started having periods--regardless of the progesin,etc...  In spite of that I felt stronger and less PVCs than I'd had in a very long time.  Now, over 4 mos later, i think the "goodies" are all gone and the PVC's are worse than ever all of a sudden.  It got bad just two days ago when I started spotting.  I first up'd the progesterone & felt even worse, then cut it out all together, the spotting has all but stopped, but the PVC's are really bad. (same as when I was on Progesterone) No hot flashes back yet.  

I don't have them when I exercise (if I start slow--as always), and don't have them ALL day long, but worse sitting down or late at night.  However, I'm sitting on the edge ALL day long.  I think it's the hormonal swing back to low Estrogen.  They have not been a long string of them, but just hit me "wham" in the back & I feel the skip, then it may do it again in 5 minutes or 15 minutes.

I've been on Sectral 200 mg 2xday & Klonopin as needed. (for a long time)  I've been taking Klonopin the last couple days trying to make them stop.  Nothing seems to help.  I'm not addicted to Klonopin.  One bottle lasts me several months.

I do plan to get another blood test this week for hormone levels.  Do you know how long these AWFUL PVC's that hit like a hammer in the back will last before my body adjusts itself?  Please help if you can.  Thanks

[canihelp]

I went to my GYN doctor for years complaining of the estrogen dominance I was having.  She only suggested some Progesterone to off-set that this last year.  I could have had a lot less PMS symptoms for years had I known about some other options. (which included PVCs as the most troubling)  It was when I found the doctor who was medical, as well as homeopathic, that I finally got answers to the hormone problem.  The cardiogists will not write anything out or recommend anything except for just HEART MEDICINES.  I'd like to see them get more informed, to help people like me.  I have a good heart but have suffered for years in need of something other than what the Cardiologists would try.  

thank you for your time and effort.  I guess doctors can't be all things to all people.  We expect too much from them.  Sure glad we have them though!!!

Regards.

[Michael J. McWilliams, M.D.]

If you have structurally normal heart and other wise normal EKG, you will be ok.  You mentioned symptoms so I addressed ways to try an alleviate symptoms.  If you are afraid to leave the house, it sounds like there is a fairly strong anxiety component as well.

There are no studies addressing your concerns directly so I don't think you will find the answer you want about estrogen trochees or even HRTS.  Sorry I couldn't be of more help.

[canihelp]

I am on fairly strong beta blocker.  And the type of hormone pellets I got was "natural" estridol, etc.. The Progestin was by mouth, formulated by natural compounding pharmacy.  I don't think the risks are the same with them, but I could be wrong.  If I go with more hormones, I'd try the Trochees, which go under the tongue.  Life is too limited if the PVCs are too bad.  I can't even leave the house for fear of an attack.  I had gotten so strong and feeling young with the pellets, but the estrogen was too strong.

I was hoping you had heard of this problem before and had some advice (other than HRTS) that could help.  Or reassurance that I'll be ok!  Thanks for your help anyway.

[Michael J. McWilliams, M.D.]

The direct answer to your question is that I cannot tell you how long they will last.  PVCs tend to come and go in spurts and we have little control over when they happen.  Some people do notice, as you have, that hormonal changes will cause an increase in symptoms.  The best option is to wait it out and see when they will stop or slow down.  Other options include trying beta blockers and / or calcium channel blockers.  I would be reluctant to do hormonal replacement to reduce PVCs but if you understood the potential risks, it might be worth a try.  The risks would include a slight increased risk of cardiovascular events (this is often debated) and a slight increased risk of some forms of cancer. I personally have never given estrogen to anyone to decrease PVCs.

One more comment -- it  is possible that you have fewer PVCs during the day, but it is also possible you don't notice them as much when you are moving around compared to sitting still.

I hope this helps and that you find relief soon.